• Title/Summary/Keyword: Esophageal dysphagia

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Upper esophageal web with dysphagia and Iron-deficiency Anemia [Plummer-Vinson syndrome] - A case report - (철분 결핍성 빈혈을 동반한 Esophageal Web [PlummerVinson Syndrome]치험 1)

  • Kim, Ju-Hyeon;Na, Myeong-Hun
    • Journal of Chest Surgery
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    • v.20 no.2
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    • pp.374-378
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    • 1987
  • Plummer-Vinson syndrome is also termed Paterson-Brown-Kelly syndrome and sideropenic dysphagia, because it was described originally by Paterson and Kelly in 19`19 and it was often combined with iron-deficiency anemia. The syndrome is encountered most often in middle-aged anemic female. It is characterized by dysphagia referred to the upper esophagus, atrophy of the oral or pharyngeal mucous membranes, koilonychia, and stenosis or webs of the upper esophageal mucosa. And it is also related to the late occurrence of the carcinoma of the upper esophagus. Here is presented a case of upper esophageal web with dysphagia and iron-deficiency anemia with review of literature, which was treated by the surgical esophagoplasty to relieve the symptom of dysphagia and to widen the upper esophageal narrowing.

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Congenital Esophageal Stenosis - 1 case - (선천성 경부식도 협착증 - 1예 보고 -)

  • 문석환
    • Journal of Chest Surgery
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    • v.22 no.3
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    • pp.514-517
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    • 1989
  • Congenital esophageal stenosis is a rare disease in childhood. By virtue of its complex embryological development, the esophagus is the site of many congenital abnormalities. Congenital Esophageal stenosis is one tenth as rare as tracheoesophageal fistula with esophageal atresia and is very rare in the cervical esophagus, which mostly occurred below mid-esophagus. Congenital esophageal web may be caused by the resorption failure of the epithelium following the vacuolization stage in embryonic development in the esophagus. Recently, we experienced 1 cases of congenital esophageal web, as the symptoms of life-long dysphagia. According to her history of dysphagia, radiologic and clinical findings, her esophageal stenosis was considered as congenital. For dilatation and relief of dysphagia, she underwent the Heineke-Mikulicz type of esophagoplasty. The results of surgical treatment were relatively good without any clinical events. So we reported it with its literature review.

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Role of Esophageal High-Resolution Manometry in Pediatric Patients

  • Prachasitthisak, Noparat;Purcell, Michael;Krishnan, Usha
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.4
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    • pp.300-311
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    • 2022
  • Purpose: Dysphagia, vomiting and feeding difficulties are common symptoms, with which children present. Esophageal function testing with high resolution manometry can help in diagnosing and treating these patients. We aim to access the clinical utility of high-resolution manometry of esophagus in symptomatic pediatric patients. Methods: A retrospective chart review was done on all symptomatic patients who underwent esophageal high-resolution manometry between 2010 and 2019 at Sydney Children's Hospital, Australia. Manometry results were categorized based on Chicago classification. Demographic data, indication of procedure, manometric findings, and details of treatment changes were obtained and analyzed. Results: There were 62 patients with median age of 10 years (9 months-18 years). The main indication for the procedure was dysphagia (56%). Thirty-two percent of patients had a co-morbid condition, with esophageal atresia accounting for 16%. The majority (77%) of patients had abnormal manometry which included, ineffective esophageal motility in 45.2%. In esophageal atresia cohort, esophageal pressurization was seen in 50%, aperistalsis in 40% and 10% with prior fundoplication had esophago-gastric junction obstruction. Patients with esophago-gastric junction obstruction or achalasia were treated by either pneumatic dilation or Heller's myotomy. Patients with ineffective esophageal motility and rumination were treated with a trial of prokinetics/dietary texture modification and diaphragmatic breathing. Conclusion: Esophageal high-resolution manometry has a role in the evaluation of symptomatic pediatric patients. The majority of our patients had abnormal results which led to change in treatments, with either medication, surgery and/or feeding modification with resultant improvement in symptoms.

Palliative Intubation in Advanced Esophageal Cancer [including esophagorespiratory fistulas] Using Celestin Tube - Report of 6 Cases - (Celestin Tube 를 이용한 진행된 식도암환자에서의 고식적 수술치료 - 6례보고-)

  • Han, Jae-Jin;Jo, Jae-Il;Sim, Yeong-Mok
    • Journal of Chest Surgery
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    • v.22 no.2
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    • pp.315-320
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    • 1989
  • Dysphagia is common symptom in patients with advanced esophageal cancer, which is not to be resected surgically. Especially when esophagorespiratory fistula is complicated, it leads to rapid deterioration and death due to pulmonary infection. Esophageal intubation relieves dysphagia as simple surgical execution and offers rapid effectiveness. For six patients with inoperable esophageal cancer including three esophago-respiratory fistulas, the palliative esophageal intubation was performed in Korea Cancer Center Hospital, in 1988. Traction technique via high gastrotomy with Celestin tube was used. Adequate palliation of dysphagia was achieved in 5 patients, but wound infection was developed in 2 patients, tube migration in 2 patients, and 2 died in hospital due to sepsis on the 16th and 42nd postoperative day, respectively. In 3 patients with esophagorespiratory fistula complicated after radiation therapy, the intubation was performed urgently and the result was satisfactory in 2 of them that the fistula was occluded successfully and aspiration or pulmonary infection was prevented.

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Surgical Management of Esophageal Carcinoma after Esophageal Prosthesis (인공 식도를 삽입한 식도암 환자의 수술치험 4례)

  • 박승훈
    • Journal of Chest Surgery
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    • v.28 no.1
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    • pp.90-95
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    • 1995
  • Effective relief of dysphagia in unresectable esophageal cancer patients not only prolong survival but also is prerequisite for other treatment modalities.We tried surgical resection in 4 patients who had unresectable esophageal cancer,managed initially with esophageal prosthesis then followed by chemotherapy with good response. Curative resection was possible in 2 patients and palliative resection in one and exploration only in one case.Curatively resected patients are alive without recurrence for 57 months,8 months,each.Other non-curatively resected patients died after 10 months,7 months. Above results suggest that initial esophageal prosthesis to relieve dysphagia followed by chemotherapy in unresectable esophageal cancer may provide another chances for curative resection that promise better survival and need more clinical experience and trial.

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A Case of Esophageal Candidiasis in a Healthy Child (건강한 소아에서 발생한 식도 칸디다증 1예)

  • Jo, Joseph;Park, Sin Ae;Choi, Kyung Dan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.269-274
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    • 2005
  • Esophageal candidiasis is an opportunistic infection, often reported in patients who have acquired immune deficiency syndrome (AIDS), a neoplastic disease, or undergoing protracted antibiotic therapy. Impaired cell mediated immunity was often considered as the major predisposing factor in patients of esophageal mucosal colonization of Candida spp. However, it is increasingly reported that the occurrence of esophageal candidiasis with no underlying disease or immune suppression. We have experienced a case of esophageal candidiasis in a 15-year-old girl who was immunologically normal and have no underlying disease and whose main symptoms were epigastric and retrosternal pain with dysphagia. This case suggests the possibilities of candidal infections in children without predisposing factors such as immune compromised conditions, so it will be needed to differentiate the esophageal candidiasis among healthy children with symptoms of odynophagia and dysphagia.

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Thoracoscopic Esophagomyotomy in Achalasia -Case Report- (흉강경을 이용한 식로근 절개술 -1례 보고-)

  • 백효채
    • Journal of Chest Surgery
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    • v.27 no.8
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    • pp.717-721
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    • 1994
  • Extramucosal esophagomyotomy by thoracotomy, first described by Heller in 1913 was the principal therapy for achalasia. Recently however, video-assisted thoracoscopic surgery has been implied in esophageal surgery, and we have experienced 23 year old male patient with dysphagia and was diagnosed as achalasia who underwent thoracoscopic esophagomyotomy. The esophagogram showed typical bird beak appearance and the lower esophageal sphincter pressure was increased to 35 mmHg. Thoracoscopic surgery was done twice due to incomplete myotomy in first operation and the patient was released of dysphagia in the second operation.

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A Case of Cricopharyngeal Dysphagia Treated by Botulinum Toxin Injection (보톡스 주입술로 치료된 윤상인두 연하장애 1예)

  • Choi, Kyu-Young;Rho, Young-Soo;Lee, Dong-Jin;Chung, Eun-Jae
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.22 no.1
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    • pp.52-55
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    • 2011
  • Hyperfunction of the upper esophageal sphincter (UES) can cause severe dysphagia. This condition referred as cricopharyngeal dysphagia may occur after head and neck surgery due to altered muscle spasm and stenosis of the pharyngo-esophageal segment. Among various treatment options available, Botulinum toxin A (Botox) injection offers a nonsurgical treatment which is useful especially for debilitated patients, and there has been a recent increase in the clinical use of Botox by otolaryngologists for managing such conditions. A 55-year-old male with base of tongue (BOT) cancer suffered from severe dysphagia after total glossectomy and neck dissection treatment. Videofluoroscopic swallow study (VFSS) and flexible endoscopic evaluation of swallowing (FEES) showed inability to pass food through the UES due to cricopharyngeal spasm. After injection of 10 U of Bot ox into each cricopharyngeus muscles (total 20 U) via EMG-guided percutaneous injection, swallowing function had improved and oral nutrition was possible, with food passing through the UES visualized on VFSS and FEES.

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Esophageal Leiomyomatosis in a patient with Alport Syndrome (Alport syndrome과 동반된 식도 평활근종증)

  • 최인석;박주철;이주희
    • Journal of Chest Surgery
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    • v.33 no.1
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    • pp.112-115
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    • 2000
  • A-13-urar-old with a history of Alport syndrome had been suffering from progressive dysphagia and postprandial vomiting for over 7 years. Exophagogram and manoemtric studies were consistent with achalasia. Barum study demonstrated marked esophageal dilatation and smooth tapered narrowing of the distal esophagus. However in spite of the medical treatment including the injection of the distal esophagus. However in spite of the medical treatment including the injection of botulinum toxin at the lesion site using an endoscope symptom did not improved and he suffered growth failure and malnutrition. Esophagectomy and esophagogastrostomy were performed to relieve the dysphagia. A firm circumferential intramural mass about 7$\times$5$\times$5 cm was found in the distal esophagus. The lumen of the esophagus was markedly dilated and esophageal wall was hypertrophied. Histologic examination of the neoplasm revealed a rather ill defined tumor tissue consisting of interlacing or whirling spindle cells without significant mitosis and esophageal leiomyo-matosis was confirmed. The patient was discharged uneventfully.

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Quantitative Analysis of Esophageal Transit of Radionuclide in Patients with Dermatomyositis-Polymyositis (피부근염-다발성근염 환자에서 방사성 동위원소를 이용한 식도 스캔의 정량적 분석)

  • Lee, Myung-Hae;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.23 no.2
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    • pp.183-188
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    • 1989
  • Esophageal transit of radionuclide was quantitatively analyzed in 29 patients with dermatomyositis-polymyositis. Fourteen patients (48.3%) showed retention of tracer in oropharynx. The mean value of percent retention of oropharynx was $15.5{\pm}16.6%$. Esophageal dysfunction was found in 19 patients (65.5%). Among them 4 showed mild, 12 showed moderate and 3 showed severe esophageal dysfunction. Dysphagia was found in 11 patients (37.9%), which was closely related to percent retention of oropharynx.Quantitative analysis of esophageal transit of radionuclide seemed to be a useful technique for evaluation of dysphagia in patients with dermatomyositis-polymyositis.

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